In many open or semi-open adoptions, the expectant mother may want the adoptive family with her at the hospital. During the time of planning for the upcoming birth, the expectant mother will probably work on a hospital plan with the agency that will most likely be shared with an adoptive family. An important point to remember is that this hospital plan is often a road map of how your expectant mother sees that she would like the process to go. An expectant mother may change her mind about her plan during labor or after the baby is born. An adoptive family needs to support her in the decisions she makes at this time. Allowing the birth mother to feel comfortable during the hospital stay may help her to have peace with the decision she is making and could also strengthen or weaken the bond between an expectant mother and the adoptive family.


It can be very important to remember that an expectant mother cannot control when she is giving birth unless a doctor schedules an induction or c-section; but even then, the baby can come earlier than scheduled. During this time, it is often important for an adoptive family not to stress the expectant mother out about travel plans, the cost involved, and their own anxiety about not knowing when the baby will be born. It often helps to plan a trip to the location of your expectant mother before the due date and know that you might be staying longer than expected as a result of waiting for labor and delivery or Interstate Compact on the Placement of Children (ICPC) between states.

Travel Arrangements

Many hospitals have rooming-in options for adoptive parents. However, this is usually based on availability only and sometimes has a fee associated with it. Even if a hospital has a rooming-in policy, if they have several deliveries at once, a room may not be available for you. If you are given a room at the hospital, remember that you will probably be sleeping in a hospital bed or on a couch much like a patient in the hospital. Sometimes they do not allow you to stay overnight. You want to make sure that you are gracious and appreciative to the hospital staff for any accommodations given and that you never complain to the expectant mother about your accommodations. Rarely is food provided to adoptive parents at the hospital, so be prepared to go to the cafeteria or a nearby restaurant during your stay. 

Labor & Delivery

Not all expectant mothers choose to have an adoptive parent in the labor and delivery room. If the expectant mother is not asking you to be with her, please do not take it personally. It may be a modesty issue and sometimes as the labor progresses, an expectant mother may change her mind about who is in the delivery room. An adoptive father is rarely in the delivery room, but if you are asked to be, accommodations can be made to help you feel comfortable with the situation.

During labor, be supportive, but read the expectant mother’s body language and listen to her words. She may just want to watch TV or sit in silence and that is ok. You could encourage her to rest. Don’t hesitate to remind her that you can step out if she needs time alone or wants to nap. Just follow her lead. Make sure not to have a meal in her room, if possible, as she will not be able to eat during her labor. You could offer to get her ice chips if needed, and just be there to support her during labor.

Once the baby is born, even if the birth mother has told you she would like you to hold the baby first, you may want to make sure she is not wanting to spend some time with the baby immediately after delivery. Feel free to step to the side and watch as the nurses care for the baby in the warmer while they are tending to the birth mother right after delivery. However, make sure that the birth mother can see and know what is going on if that is her desire. In the emotions of the delivery, you may want to make sure you choose your words carefully and do not talk in words that assume the baby is yours during those first few hours. 

Hospital Stay

Once the baby is cleaned up and ready to be held, always make sure to offer to let the birth mother hold the baby first. A simple “would you like to hold him/her?” lets her know you are thinking of her feelings at the moment. In the same vein, you probably shouldn’t insist that a birth mother hold the baby if she is letting you know that she is not comfortable with it. 

The hospital typically gives a bracelet to the birth mother and one person she designates, which can be the adoptive mother. This allows you to have access to spending time with the baby. You usually must be present in the hospital when the baby is born to be able to be provided this wristband and the birth mother must designate by word or writing that you are to receive it. If the birth father is involved and with her at the hospital, she may choose to provide that band to him. If this happens, typically the birth mother can let the hospital know that she would also like you to have access to the baby and an extra band may be made. 

If a hospital room is not available at the hospital for adoptive parents, there is usually an option to spend time with the baby in the birth mother’s room, in the nursery, or the NICU. Be flexible and appreciate any chance and location to spend time with the baby during these 48 hours or whatever length of time the baby is in the hospital. 


You may have to be careful not to call yourselves “Mommy” or “Daddy” in front of the birth mother. Oftentimes, this can trigger emotions in her that she did not expect. Another thing to keep in mind is to perhaps be careful not to take family pictures with the baby in front of the birth mother unless she requests them. Always be mindful of her feelings as she is watching you interact with the baby. It could be good to include her in photos and you can make her feel important by telling her how much you would love to document these moments for the baby. However, you should probably ask if she is comfortable taking pictures beforehand and never take pictures of the birth mother without her permission.


If there are needed diaper changes or bottles to feed, you could offer the birth mother a chance to take this job on if she would like before you do so. Some women enjoy this time and like to feel needed; however, some do not. If she says she doesn’t want to change a diaper or give a bottle, make sure not to encourage it or insist. 

Sometimes a birth mom might want the baby in the room with her overnight. This does not always mean that she is rethinking placing her baby for adoption. Often, a birth mom could be wanting a little time with the baby to prepare to say goodbye to him or her. If this happens, you should support her in her decision rather than let her know that you do not think it is a good idea for her to do so. 

There have been times that a birth mother might ask an adoptive mother to stay in the room with her overnight with the baby. Even if this might be out of your comfort zone, remember that this might be something she is needing to help get her through a tough night. It is usually not a common occurrence, but telling a birth mother that you would rather not do so may create hurt feelings. 


Always remember that during the hospital stay, your birth mother may be watching everything that you do:  how you speak to staff, to her, and one another. Relationships between adoptive families and birth mothers can be affected by the way you react to stress at the hospital. The hospital is probably not the time to let a birth mother know how tired you are and how little sleep you are getting. 

Some birth mothers may choose to have friends or family come to see the baby. During these times, you may want to ask her if she would like you to be present during those visits or step out to give her time alone with guests. Remember that the birth mother’s friends and family may also be watching how you react, and you probably want to make sure that you do not create an awkward situation for them. If she would like you to stay in the room when her guests arrive, you could try interacting with them as opposed to taking the time to check your phone or do other things. 


You may want to spend time with your birth mother unless she has requested to be alone. You may learn a great deal about her and her background by sharing a meal or watching a tv show or movie together. You could offer to bring her dinner one night in the hospital. Even if she does not want the baby in her room, you could offer for one of you to spend time with her in her room. 

Another thing that can be important is to make sure to take interest in your birth mother at the hospital. If she has the baby in the room, you could make sure to enter and talk with her before seeing/reaching for the baby. It can be very important to make sure that she knows that she is valued and appreciated. 

Parental Rights

Remember that until the baby is 48 hours old and parental rights are relinquished (or the guidelines set by your state have been reached), the birth mother will probably be the one to make medical decisions for the baby and the hospital staff will provide her primarily with medical information. The pediatrician may check the baby out in the presence of the adoptive parents and provide them with medical information, but this is not always the case. You may also come across nurses who will speak to the birth mother about the baby instead of you. In this case, try to go with the flow and remember that everyone at a hospital may not be comfortable or knowledgeable about the adoption process

A social worker from the hospital is usually required to speak with the birth mother alone before she leaves the hospital. Most times this is not to talk her out of her decision, but rather to make sure that she is deciding on her own without the influence of others. Often during these conversations, a social worker can determine if a birth mother is needing services outside of the placement and can provide resources at that time. 


The birth mother is usually the one who fills out the birth certificate at the hospital. Sometimes they will have a name that is special to them and other times they will want to put the name you choose. If you have not talked with your birth mother about a name before the hospital, you may want to make sure you ask about the origin of the name she chose. Oftentimes it is a name that is special to her and you might want to incorporate it yourself. If you choose not to keep a part of the name the birth mother has selected, you probably want to use your words carefully to let her know the meaning of the name you have chosen. 

If the birth mother is open to it, you could take a picture of all of you together before leaving the hospital. This is something that could be special to her and maybe appreciated by your child. 


Even the strongest birth mother might have a hard time letting go of the hospital. Remember to love her through the process and remember the grief that she is going through during those days. 

It is usually ok to admit to your birth mother that you are nervous or do not want to say the wrong things. She is probably feeling the same way. 

Above all else, one thing that you could make sure of is to let the birth mother know how much you appreciate the gift she has given you. You can probably never say “thank you” too many times.

Always remember that as your child grows up, they will probably ask you about those first days. You may have a situation with a birth mother who did not want to have contact with you at the hospital, and you can explain that to your child one day; however, if you get the opportunity to make memories with your child’s birth mother, you can take notes, keep a journal, and let your child know that beautiful story of their arrival into the world.

Marcy Pederson
Marcy Pederson